Bulimia
Bulimia, or bulimia nervosa, is an eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors, such as self-induced vomiting or laxative abuse, to prevent weight gain. This disorder primarily affects the gastrointestinal system but can have serious implications for various bodily systems, including the heart, brain, and dental health. Individuals with bulimia often have a distorted body image, feeling overweight despite being at a normal weight, and may suffer from associated psychological issues such as depression and anxiety. The disorder disproportionately affects young women, though increasing numbers of men, particularly in the LGBTQ community, are being diagnosed. Factors contributing to bulimia can include childhood experiences, family dynamics, and societal pressures regarding body image. Treatment typically involves a combination of psychotherapy, nutritional counseling, and medication, aiming to address both the psychological and physical aspects of the disorder. While some individuals may experience short episodes of bulimia, others may struggle with it for years, highlighting the importance of effective diagnosis and intervention strategies. Recent advancements in diagnostic techniques, such as analyzing hair samples, show promise for more accurate and timely identification of eating disorders.
Bulimia
DEFINITION: An eating disorder that is characterized by repeated, uncontrollable episodes of overeating followed by induced vomiting or laxative abuse to eliminate the undigested food.
ALSO KNOWN AS: Bulimia nervosa
ANATOMY OR SYSTEM AFFECTED: Blood, brain, gastrointestinal system, gums, heart, intestines, musculoskeletal system, nerves, psychic-emotional system, teeth
CAUSES: Emotional and psychological disorders pertaining to body image
SYMPTOMS: Intense preoccupation with food and weight; eating binges followed by self-induced vomiting, ingestion of laxatives, or excessive exercise; depression; suicidal feelings; nutritional deficiencies; dehydration; hormonal changes; menstrual problems; gastrointestinal problems; heart disorders; persistent sore throat; tooth and gum damage
DURATION: Chronic
TREATMENTS: Psychotherapy, nutritional counseling, medication
Causes and Symptoms
Bulimia is typically regarded as a psychologically based disorder caused by childhood experiences, family influences, and social pressures, particularly on young women to be thinner than natural. Many people who develop bulimia have been overweight in the past and suffer from poor self-image and depression. Body weight is often within normal limits, but persons with bulimia perceive themselves as fat and are often obsessed with their body image. Others may have a history of sexual or physical abuse or of alcohol or drug abuse. Medical research suggests that bulimia may be partially caused by impaired secretion of cholecystokinin (CKK), a hormone that normally induces a feeling of fullness after a meal, or by depletion of the chemical serotonin in the brain, which contributes to a craving for carbohydrates.
Though research has shown that the vast majority of individuals diagnosed with bulimia are women and girls, increasing numbers of men are being treated for the disorder. In the decade from 2008 to 2018, the number of males diagnosed with eating disorders increased by 70 percent. About 30 percent of the estimated ten million American men with eating disorders are estimated to have bulimia. Experts believe males are consistently underdiagnosed and researched and that prevalence of eating disorders in the LGBTQ community, whose members typically face stressors particularly in adolescence, also warrants further study.
Intense preoccupation with food and weight are invariably present, and eating binges are followed with self-induced vomiting or the ingestion of laxatives to rid the body of the consumed food. Depression and suicidal feelings sometimes accompany bulimia. The disorder can cause nutritional deficiencies, dehydration, hormonal changes, gastrointestinal problems, changes in metabolism and blood chemistry, heart disorders, persistent sore throat, and teeth and gum damage as a result of the acidic nature of regurgitated food.
Treatment and Therapy
Treatment of bulimia requires a combination of nutritional counseling, medication, and psychotherapy. Psychotherapists try to get to the root of any underlying psychological problems and resolve them. Various modes of group and cognitive behavioral therapy have proven effective.
Cognitive therapy usually includes confronting people with bulimia about their inaccurate perceptions of body weight and making contracts with them to shift their focus to nutrition rather than weight gain in exchange for rewards. Group therapy has helped many bulimics stop their binge eating, while treatment with antidepressant drugs, especially fluoxetine (Prozac), has helped many bulimic patients gain partial or full relief from their symptoms. Hospitalization is a common treatment and is virtually always necessary if body weight is more than 30 percent below ideal.
Perspective and Prospects
Bulimia was classified as a distinct disorder by the American Psychiatric Association in 1980; the name was officially changed to bulimia nervosa in 1987. The disorder occurs mostly in adolescent and young adult females, with about 10 percent of cases in males. Many cases of bulimia end after a few weeks or months but may reoccur. Other cases last for years without interruption.
Researchers developed a test that analyzes carbon and nitrogen in hair, which is suggestive of eating disorders. This technique is beneficial because eating disorders are difficult to diagnose, in part because sufferers sometimes do not know that they have an eating disorder or do not want to be honest. By analyzing just five strands of hair, researchers were able to diagnose anorexia and bulimia accurately 80 percent of the time. This test may hasten treatment and prove an effective and objective method of monitoring recovery.
Bibliography
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